By Lindsay Morris
Discover the evidence-based supplements that may help support fertility, egg quality, and hormone balance for women over 35.
In this article:
You’ve embraced a healthier lifestyle, you’re tracking your cycle, and now you’re ready to take the next step toward trying to get pregnant. Fertility does shift after 35, but there are still proactive steps you can take to support your reproductive health. While there’s no magic pill, research shows that certain supplements may help improve egg quality, balance hormones, and promote overall wellness. The challenge is knowing what to choose when faced with shelves full of prenatal vitamins and fertility blends.
If you’re looking for the best fertility supplements for women over 35, you’re in the right place. This evidence-based checklist highlights the key vitamins and natural fertility boosters that may support your journey.
Folate
Folate, also known as vitamin B9, occurs naturally in foods like spinach, Brussels sprouts, beef liver, and legumes. Folic acid is the synthetic version found in supplements and fortified foods. Research shows that adequate folate intake before conception and during early pregnancy can prevent up to 70% of neural tube defects (NTDs), such as anencephaly and spina bifida.
The reality? This level of prevention is rare, often due to confusion over which form to take, when to start, and how much is needed.
Because nearly half of pregnancies in the United States are unplanned, and neural tubes close as early as 28 days after conception, any woman of reproductive age should start taking folic acid to help with NTD prevention.
Since 1998, the United States has required food companies to add folic acid to enriched grains, including flour, cereals, bread, cornmeal, pasta, and rice, sold in the country. Folic acid fortification mandates show promising results, providing an estimated 100–200 mcg of folic acid per day to reproductive women and resulting in about 1,300 babies born annually without an NTD who might have been affected in the past.
Still, health equity remains a concern. Hispanic/Latina women may face a greater risk of folate deficiency due to genetic factors and lower access to fortified wheat products.
In 2016, the FDA began allowing the voluntary fortification of corn masa flour (commonly used for corn tortillas) to help address this disparity. The state of California took it a step further with Governor Gavin Newsom signing Assembly Bill 1830, a law that requires corn masa manufacturers to add 0.7 milligrams (mg) of folic acid to every pound of wet masa and declare the fortification on nutritional labels. The legislation goes into effect in 2026.
Despite government efforts, daily use of multivitamins has declined among Hispanic/Latina and non-Hispanic White women aged 25 to 44, with a decrease of approximately 10% among women aged 34 to 44 between 2006 and 2016. A CDC study found that more than half of women report eating enriched grains as their only source of folic acid. Researchers estimated that by adding supplements to the mix, these women could prevent as many as 700 additional cases of NTDs each year.
When shopping for folate supplements, it’s important to read the label carefully. Some manufacturers who market their products as “natural” may list other forms of folate, such as 5-MTHF, instead of folic acid. Be sure that your bottle specifically lists folic acid as an ingredient, as it’s the only form of folate demonstrated to reduce the risk of NTDs.
Suggested dosage: The Centers for Disease Control and Prevention (CDC) recommends that women who are pregnant or planning to become pregnant take approximately 400 micrograms (mcg) of folic acid in addition to folate from food sources.
Key takeaway: Folate may reduce the risk of neural tube defects.
Coq10
Your body naturally produces CoQ10—short for coenzyme Q10—a fat-soluble compound also known as vitamin Q10, ubiquinone, or ubidecarenone. CoQ10 acts as an antioxidant to support cell function, and its levels decrease with age. People with medical conditions such as cardiovascular disease and those who take statins to lower their cholesterol may also have lower levels of CoQ10 in their bodies.
While CoQ10 exists in certain foods, such as meat, fish, and nuts, the amount present is often insufficient. Instead, most people increase their body’s CoQ10 availability by consuming it in capsule, chewable tablet, and syrup form. Some patients have received CoQ10 intravenously. As a supplement, it’s been used to treat heart conditions and migraines.
Recent research suggests that CoQ10 may benefit women with diminished ovarian reserve (DOR), characterized by reduced egg quality and quantity. DOR occurs as we age, negatively affecting our fertility and leading many women to seek assisted reproductive technology (ART), including in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).
A meta-analysis and review published in December 2024 in Annals of Medicine linked CoQ10 supplementation in women undergoing IVF or ICSI treatment with improvements in clinical pregnancy rates, the number of oocytes (egg cells) retrieved, estradiol levels on the day of the hCG (human chorionic gonadotropin) injection, and the number of high-quality embryos with the best chance of implantation and successful pregnancy. The supplement was also associated with fewer canceled IVF or ICSI cycles and lower miscarriage rates. Researchers additionally observed a shorter duration and reduced dosage of gonadotropins (Gn), fertility medications used to stimulate the ovaries. Simply put: CoQ10 may give your eggs a much-needed energy boost as you get older.
The supplement may offer benefits beyond fertility treatment: a randomized study involving 235 pregnant women, published in April 2009 in the International Journal of Gynecology and Obstetrics, reported that supplementing with CoQ10 could reduce a woman’s risk of preeclampsia by 44%.
Suggested dosage: A meta-analysis published in an August 2024 issue of Advances in Nutrition found 30 mg per day of CoQ10, taken for three months prior to controlled ovarian stimulation, significantly improved pregnancy rates in women undergoing ART. Consult your health care provider for the right dosage for you.
Key takeaway: CoQ10 may support egg health and hormone balance in women over 35. If you’re considering supplementation, talk with your doctor.
Omega-3 Fatty Acids
Omega-3 fatty acids (or omega-3s) are polyunsaturated (healthy) fats essential to providing cells with structure and support. You can find them in three forms: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), found in fatty fish like tuna or mackerel, and alpha-linolenic acid (ALA), found in plant foods like ground flaxseed, walnuts, and edamame. To conveniently meet daily needs, many women take omega-3 supplements in the form of fish oil and flaxseed oil capsules, pills, or liquids.
One study published in May 2022 in Human Reproduction demonstrated that women who consumed omega-3 supplements were about 1.5 times more likely to give birth naturally than those who didn’t.
Whether you choose fish oil versus flaxseed oil often depends on your dietary preferences. However, there is some evidence that flaxseed may be more effective than fish oil in reducing insulin and inflammation in the body. Lowering insulin resistance and inflammation levels has been associated with improved hormone balance and better fertility outcomes. These findings are particularly promising for women with polycystic ovary syndrome (PCOS), a common cause of infertility. Between 35% and 80% of women with PCOS have insulin resistance, and omega-3s may benefit PCOS patients.
Suggested dosage: According to a clinical practice guideline published in December 2023 in the American Journal of Obstetrics and Gynecology, women of childbearing age should consume at least 250 mg of omega-3 supplements per day, with an increase of 100 to 200 mg per day during pregnancy.
Key takeaway: Omega-3s may improve fertility, support hormone balance, and reduce insulin resistance and inflammation, particularly benefiting women with PCOS.
Inositol
Your body naturally produces inositol, also known as vitamin B8, from glucose. The molecule, which is no longer considered a true vitamin, plays a role in healthy cell structure and function. While you can find it in various foods, such as meat, legumes, grains, corn, and beans, the average American consumes only about 1 gram (g) of inositol per day. Therefore, many physicians recommend inositol supplements, including myo-inositol (also known as myo-ins), inositol hexaphosphate, and D-chiro-inositol.
Clinical trials have demonstrated the effectiveness of myo-inositol in increasing the chances of pregnancy and preventing gestational diabetes mellitus and the onset of neural tube defects. It may also enhance oocyte and embryo quality in women undergoing ART. There is also evidence that inositol supplements may help treat PCOS.
Suggested dosage: The daily therapeutic inositol dosage typically ranges from 12 to 18 g, usually divided into two to three doses per day. The supplement is available in pill form and as a powder that can be dissolved in water or juice for those who have trouble swallowing pills.
Key takeaway: Inositol not only supports metabolic health but may also improve egg quality, enhance fertility, and help prevent gestational diabetes and neural tube defects.
Vitamin D
Vitamin D helps your body absorb calcium, which is essential for maintaining strong bones. It also allows your muscles to move and your nerves to facilitate communication between your brain and the rest of your body. And it benefits your immune system.
Not many foods naturally contain vitamin D. While cheese, egg yolks, beef liver, and mushrooms contain small amounts of the vitamin, you’ll more commonly find it in fortified foods, such as milk. Even then, the beverage only provides about 3 mcg or 120 international units (IU) of vitamin D per cup.
You may have heard that sunlight can help increase vitamin D levels. While it’s true that your body produces the vitamin when your bare skin is exposed to the sun, factors such as clouds, smog, having dark skin, sunscreen use, and old age can reduce the amount it produces. That said, exposing your skin to ultraviolet radiation from sunlight increases your risk of skin cancer. For many people, supplements provide a more convenient and safer way to meet their vitamin D needs.
People with PCOS frequently suffer from vitamin D deficiency. According to a review published in April 2022 in Nutrients, supplementing the diet with vitamin D may help prevent pregnancy-related reversible bone loss.
Suggested dosage: The National Institutes of Health recommends that adults aged 19 to 71 take 15 mcg or 600 IU of vitamin D. Pregnant and breastfeeding teens and adults should take 15 mcg or 600 IU.
Key takeaway: Vitamin D benefits bone health and strengthens the immune system, while potentially preventing pregnancy-related bone loss in PCOS patients.
Bottom Line
While no supplement is guaranteed to get you pregnant, research shows that certain nutrients may support reproductive health. Still, it’s important to note that the FDA has not approved products claiming to treat infertility. Under the Federal Food, Drug, and Cosmetic Act, supplement manufacturers must obtain FDA approval before marketing products as treatments or cures for medical conditions.
Every woman’s body is different, and your doctor may recommend specific supplements based on your diet, medical history, or other personal factors. Always consult your healthcare provider before adding new supplements to your routine.